Weekend-Shift Florida Medical Management Nurse (Remote)

The Elevance Health Companies, Inc.; Miami (FL); Hybrid; USD 75,000 - 95,000; Full time

Job summary

The Elevance Health Companies, Inc. is seeking a Florida Medical Management Nurse for weekend shifts (4/10s Sat-Tue 7AM-6PM EST) with virtual work options for training sessions. Candidates must reside in Florida and have an active RN license; multi-state licensure may be required.

The role focuses on clinical analysis, case management, and collaboration with providers to optimize member care. You will participate in discharge planning, educate members about plan benefits, and support leadership

Qualifications

• Requires an associate’s degree in nursing.
• Minimum 4 years of care/case management experience and 2 years in clinical/utilization or managed care.
• Current active, valid and unrestricted RN license in applicable states.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Analyze members’ clinical information and assess medical necessity.
• Collaborate with healthcare providers to optimize member outcomes.
• Provide consultation to the Medical Director on complex cases.
• Assist with discharge planning and patient education.
• Participate in process improvement and training activities.

Skills

Nursing judgment

Clinical assessment

Provider collaboration

Case management

Discharge planning

Plan benefits education

Education

Associate degree in nursing

Job description

The Elevance Health Companies, Inc. is seeking a Florida Medical Management Nurse for weekend shifts (4/10s Sat-Tue 7AM-6PM EST) with virtual work options for training sessions. Candidates must reside in Florida and have an active RN license; multi-state licensure may be required.

The role focuses on clinical analysis, case management, and collaboration with providers to optimize member care. You will participate in discharge planning, educate members about plan benefits, and support leadership